Recovering alcoholics who abstain from drinking are least likely to relapse

Recovering alcoholics whose chosen strategy is to abstain from drinking are least likely to relapse, according to a new study of a nationally representative sample of adults.

However, although abstinence is the most reliable form of recovery to help middle-age and older adults avoid alcohol abuse and dependence problems, the study found that sustained recovery might be more elusive for young people, regardless of whether they avoid all alcohol or simply restrict their consumption.

"The biggest surprise was how little abstinence did to improve the prospects for younger alcoholics remaining in remission. To my knowledge, no one has looked at this age differential before," said lead study author Deborah Dawson, Ph.D. She is a substance abuse researcher with the National Institute on Alcohol Abuse and Alcoholism.

The study appears in the December edition of Alcoholism: Clinical and Experimental Research . The article examines results from the National Epidemiologic Survey on Alcohol and Related Conditions.

Dawson's team analyzed the recovery status of more than 1,700 adults who were in some form of recovery at the beginning of the study, but who had been dependent on alcohol in the past.

Researchers grouped the participants into three categories: 1) abstainers, people who said they did not imbibe alcohol; 2) low-risk drinkers, people who drink at levels lower than those thought to increase the risk for relapse; and 3) asymptomatic risk drinkers, people who do not have any symptoms of alcohol abuse or alcohol dependence, but who drink more than the recommended guidelines for low-risk drinking.

The team interviewed study participants in 2001 and 2002, and again in 2004 and 2005.

The alcoholics who were abstainers at the beginning of the study were most likely to still be in recovery - and symptom free - at the second wave of the survey. Fifty-one percent of the asymptomatic risk drinkers had experienced the recurrence of alcohol dependence symptoms, compared with 27.2 percent of low-risk drinkers and 7.3 percent of abstainers.

"The most commonly reported symptoms of dependence in this study were repeatedly trying to stop or cut down on drinking, drinking more or for longer than intended and problems with sleeping, nausea or restlessness when the effects of alcohol were wearing off," Dawson said. "The most commonly reported abuse symptom was driving after drinking too much."

Abstaining worked best for alcoholics older than 25, the study found. The benefits of abstinent recovery were not as strong for younger individuals. "Youthful abstainers are still at high risk," Dawson said.

It is not clear why abstinence does not work as well for young drinkers, but the authors said the high risk for relapse among people age 18 to 24 begs for more study and signals a significant treatment and prevention challenge for the legal system and college campuses.

Health researcher Lee Ann Kaskutas says it is too soon to discount the benefits of abstinence for young alcoholics.

"It may be that these very young drinkers just haven't lived long enough - or had time to experience the cycle of failure and success - to allow abstinence to work," said Kaskutas, director of training at the Alcohol Research Group in Berkeley, Calif.

Alcoholism: Clinical and Experimental Research : Contact Mary Newcomb at (317) 375-0819 or mnewcomb-acer@earthlink.net or visit http://www.alcoholism-cer.com

Dawson DA, Goldstein RB, Grant BF. Rates and correlates of relapse among individuals in remission from DSM-IV alcohol dependence: a 3-year follow-up. Alcoholism: Clinical and Experimental Research 31(12), 2007.

http://www.hbns.org

source: news-medical.net

Ask: "Why not 21?"

By Stephen Wallace

Renewed public discourse about the advisability of lowering the legal drinking age, largely fueled by former Middlebury College President John M. McCardell, Jr., has opened a different front in the war on substance use and abuse among young people. While some have tired of the now decades-old debate, a fresh round of honest discussion by informed public policy-makers and pundits can only inure to the benefit of those with the most at stake.

Among McCardell's many arguments for issuing drinking "licenses" to 18- to 20-year-olds are suggestions that the current legal age of 21 breeds disrespect for the law, deprives parents of opportunities to teach children to drink responsibly, and drives problem drinking further underground and out of sight of those who might be inclined to help.

But addressing this epidemic by enabling it would be akin to suggesting that we can solve the problem of speeding by doing away with speed limits, pointed out Dr. Robert DuPont, president of the Institute for Behavior and Health and former director of the National Institute on Drug Abuse.

As for the parents, SADD's Teens Today research reveals that those who allow their children to learn to drink at home actually incite significantly more drinking elsewhere. And arguing that moving the legal drinking age to 18 will magically transport alcohol use out of the shadows and into the light overlooks the fact that young people use alcohol today much differently than they did even a decade ago. High-risk, or "binge" drinking, something McCardell cites as a relatively new phenomenon, has become more of a means to an end (getting drunk) for many youth rather than part of a larger social strategy. And that is unlikely to change with a lower drinking age.

In truth, there are many reasons that young people are drinking alcohol and drinking it in large quantities, including genetics, social environments, and such mental health triggers as stress, anxiety, and depression. Simplifying complicated etiology bypasses important issues related to healthy human development.

While some dismiss McCardell as nothing more than an annoying "gadfly," many in the medical and prevention communities are responding to his proposals by rallying behind a re-statement of the relevant facts, now branded Why 21?

On the why21.org Web site, MADD sets up and promptly rebuts five myths about underage drinking and drinking laws, addressing, for example, the "forbidden fruit" issue, the "If I am old enough to go to war I am old enough to drink" argument, and the worn (and false) "Europe doesn't have these problems" analogy.

In contrast, the testimony on the other side sometimes seems aimed more at assuaging the inconvenienced than at best serving America's youth. The Chronicle of Higher Education reported that, during his tenure as a college president, McCardell came to "resent" the law because it forces administrators to "choose between policing their students and looking the other way." Similarly, J. Lee Peters, vice president for student affairs at the University of Hartford, said t the law "undermines" his relationships with students.

But perhaps the undermining actually occurs when those charged with educating young people downplay a public health crisis that threatens the safety of those with whom they are trying to forge meaningful relationships in the first place.

Even some of the statistics used to bolster the argument for lowering the drinking age appear to reinforce the imperative that alcohol be restricted among less physiologically and socially mature populations. These include one cited by Indiana University Professor Ruth Eng that says 22 percent of all students under 21 years of age, compared to 18 percent of students over 21, are heavy drinkers.

According to The Surgeon General's Call to Action to Prevent and Reduce Underage Drinking, alcohol use by young people is a leading contributor to death from injuries, plays a significant role in risky sexual behavior, increases the risk of assault, and is associated with academic failure and illicit drug use. Specifically, this important report highlights that:

— An estimated 1,700 college students die each year from alcohol-related injuries; Approximately 600,000 students are injured while under the influence of alcohol; 700,000 students are assaulted by other students who have been drinking; and about 100,000 students are victims of alcohol-related sexual assaults or date rapes.

Just as significant, the report points to emerging facts about the permanent damage alcohol can inflict upon the structure and function of still-developing adolescent and young adult brains.

Undoing the current minimum-age drinking laws would likely do little, if anything, to reduce problematic drinking behaviors on college campuses and most assuredly would contribute to the downward age-trending of initiation into alcohol use by legally moving it into the high school community. It is pertinent to note that, according to Teens Today, students in grades 6-12 ranked the drinking age as the number-one reason why they choose not to use alcohol.

No matter how inconvenienced they may be, conflicted adults are a huge part of the problem rather than even a small part of the solution. By turning a blind eye, they perpetuate the fallacy that drinking by youth is really no big deal. By contrast, U.S. Health and Human Services Secretary Michael O. Leavitt, in introducing the Surgeon General's report, stated with much-needed clarity, "Underage alcohol consumption is a major societal problem with enormous health and safety consequences."

Given that, might we be better off asking, "Why not 21?"

Stephen Wallace is national chairman and chief executive officer of Students Against Destructive Decisions, Inc.

Britain is cocaine capital of developed world, with more abuse than U.S. for first time

Britons have now overtaken Americans as the biggest cocaine users in the developed world, European drug analysts said today.

Nearly one in 20 took the drug last year as cocaine replaced cannabis, ecstasy and amphetamine as the most fashionable choice among the young.

The boom in cocaine brought a fierce warning from the analysts that the drug may now be starting to have "a major impact on public health".

The report by the Lisbon-based European drugs monitoring agency signals a new landmark in the rising level of abuse of cocaine.

For decades Americans have been the chief users of the drug, which has been cheaply and easily available in US cities. Until the last decade, cocaine was usually seen in Britain as the preserve of pop stars, City traders, and the wealthy.

Now low prices, increasing supply and the unpopularity of other drugs has meant that Britain - together with Spain - has the highest levels of consumption among the young.

Figures collected by the analysts show that 4.9 per cent of men and women aged between 15 and 34 used the drug in Britain last year - around 800,000 young people.

In America, the percentage of young people that used cocaine over the same period was 4.8 per cent.

British cocaine consumption among the young was at more than twice the European average of 2.4 per cent.

The most alarming figures on cocaine in Britain showed high levels of cocaine abuse among 15 and 16-year-olds: six per cent of teenagers at or below school-leaving age have tried the drug.

The report by the European Monitoring Centre for Drugs and Drug Addiction said: "Cocaine is now, after cannabis, the second most commonly used illicit drug."

It added that "socially integrated" cocaine users - those who hold down jobs and live respectable lives as opposed to the criminals and prostitutes who often take the drug in the form of crack - are at high risk.

"The drug is usually snorted," the report said. "Many users are also using other substances including alcohol, tobacco, cannabis and stimulants other than cocaine.

"This kind of polydrug consumption can lead to elevated health risks."

The report added that there was evidence that cocaine has "out-stripped ecstasy among club-goers as the most commonly used stimulant, with the drug gaining increased acceptability among some groups".

Evidence from surveys taken in dance clubs suggested "a replacement of other stimulants by cocaine could have taken place".

It said that cocaine use had appeared to be levelling off but "the general picture of a stabilising situation is called into question by new European data which point to an overall increase in use".

The report found that Denmark and Italy has shown the greatest increases in cocaine use over a year, but levels in the highest consumption countries, Spain and Britain, were still going up.

Prevalence of cocaine was similar in Britain and Spain, but Spain is the chief gateway country into Europe for cocaine imported from Latin America, the report said.

The findings come at a time when ministers have been congratulating themselves over a decline in levels of use of cannabis among young people in Britain, a fall that has come despite the confusion and controversy over Labour's decision to downgrade the criminal status of cannabis.

However the report said that cannabis - still smoked by 21.4 per cent of people under 24 in Britain last year - is increasingly intensively used by some. This, it added, is causing "health concerns".

Mary Brett of the campaign group Europe Against Drugs said: "Older teens are turning to cocaine instead of cannabis.

"Cocaine is cool, it's getting cheap, and cannabis is out of fashion. A lot of teenagers understand now that cannabis causes psychosis.

"It used to be people in their 20s that used cocaine, but now it is teenagers. Young people need proper drug education in schools that is about prevention, not about harm reduction for those that choose to use drugs. We need to tell them about the harm that drugs do."

Tories promised tougher punishments for drug offenders, new programmes to encourage drug users to stop, and a border police force to cut imports of drugs.

Shadow Home Secretary David Davis said: "Drugs destroy lives, wreck communities and fuel many other crimes. Labour has failed to get a grip on the drug culture in this country because their approach has been designed to ignore the issue if possible and do the very least if forced to.

"Pushers are 'punished' with warnings or fines and, instead of helping addicts beat addiction, they spend half a billion pounds pursuing a policy of managing addiction. It is a strategy of keeping people on drugs."

Home Office minister Vernon Coaker promised a new Government drugs strategy next year.

He said: "Drug use in the UK is stabilising. Drug related crime has fallen by a fifth since 2003, reducing harm to communities, while drug use is at its lowest level in 11 years.

"However, I have always recognised that tackling the harm caused by drugs is one of the most formidable challenges we face."

source: The Daily Mail

Numerous fear factors deter alcoholic housewives from seeking help

The latest (2003) figures on alcohol consumption based on gender, published by the NSO, show that 36 per cent of adults in Malta drink on a regular basis. When separated by gender, females account for 25 per cent of the total number.

The incidence of alcohol consumption among middle-aged women is rising.

According to a foreign study on this subject, most women tend to start drinking later in life, usually in the 30 to 50 age group. These are usually the years when a woman is more likely to be in a relationship or married, and have children.

Although a recent study showed that the number of Maltese women who have sought help at the Zernieq facilities has never been very high, there may be reason to believe there are more women out there who are not ready to admit that they have a drink problem.

Recent foreign studies show that women are more likely to continue to take care of their children, even if they are suffering from a serious personal problem such as alcoholism. While a woman will nurse her alcoholic husband and struggle to keep the family together on her own, a man is somehow more hostile to his wife’s drinking. He sees his wife’s alcoholism as an illness that could have been avoided.

The study revealed that while most Maltese men enjoyed economic stability and the ability to distance themselves from the problem, women found it harder because they still relied on their husband for financial security, for themselves and their children.

Men preferred to leave their wives once the habit kicked in, as they found it hard to cope with their wives’ drinking.

Foreign studies show that most women who acknowledge they have an alcohol problem, still feel that they are capable of looking after their children and are committed to their welfare.

Most women were hopeful that, once they had sorted out their problem, their relationship with their husband would be re-established.

When alcohol abuse took over the lives of these women, making it impossible for them to cope with their children and their need for love, attention, supervision, food and clothing, they tended to recognise their failure and most felt guilty that they had failed as mothers.

The 2003 NSO lifestyle studies show that females are reported to drink an average of 1.1 units of alcohol per week, compared to the 4.9 units per week of men. Beer accounts for around half of the total alcohol consumed, while wine accounts for 33 per cent.

Wine accounts for 50 per cent of the total amount of alcohol consumed by females, compared with 28.9 per cent by men.

The women interviewed in this study said they found gin and whisky too expensive and therefore opted for cheaper wines they could buy from local shops. This showed that housewives drank cheap wine not because they liked it but because it was the only alcohol they could afford.

This study showed that when women, especially housewives, have substance abuse problems, these are magnified because they feel responsible for their family. They feel that they have to solve the problem on their own to avoid causing any tension or unrest in the home.

However, the absence of immediate assistance from the husband or family members will only exacerbate the problem, as these women suffer further misery. Society can be very judgmental, especially in myopic Malta, and some of these housewives tend to hide their addiction as they are afraid of becoming the subject of village

gossip.

The study also shows that they take longer to seek help, as they are too embarrassed to disclose their problem to their family and only tell them that their husband is leaving them, when this is the case. Most of the women interviewed in this study had all been drinking for quite some time before they admitted they needed help.

These housewives were also preoccupied with their children and who would take care of them once they admitted the problem, as they were afraid they would be labelled unworthy mothers and that the children would be taken away from them.

Unfortunately, the stigma linked to alcoholism ruins most women. We live in a society where women are more likely to be condemned than men.

Even though young women drinking in bars is considered “normal”, housewives of a certain age who are seen drinking heavily in public can easily earn a bad reputation and start the village gossip machine going.

The women interviewed in this study said that they preferred to drink at home to keep their addiction secret. One woman even said that she always refrained from drinking in public when out with her husband or at some family gathering. However, she got drunk on wine every day at home.

This study showed that further research into the degree of awareness of alcoholism needs to be carried out. Legal advice and psychological help could also be given to women who request it.

Changing the mentality of society is difficult. However, further education and consultation is essential to help women avoid marriage and family breakdown due to alcohol abuse.

source: The Independant Online

Addictions often fester after cultures collapse

SFU prof equates 18th century Scots with modern day aboriginals.

When it comes to the problem of drug addiction, Bruce Alexander, professor emeritus of psychology at SFU, focuses on the bigger picture. In a 2001 paper for the B.C. Centre for Policy Alternatives, he rejected the binary option of addiction as either a "criminal" problem or a "medical" problem. He insisted it's neither. "In a free market society, the spread of addiction is primarily a political, social, and economic problem."

With his courteous, low-key style, Alexander is out to demolish what he sees as one of the biggest shibboleths of our time, the "demon drug" model of addiction.

Wherever cultures are crushed and traditions lost, addictions follow, he argued last month in a speech at the Wosk Centre for Public Dialogue. He cited aboriginal people of Canada's West Coast, and moved on to a less obvious example--his ancestors from the Scottish highlands. After the Battle of Culloden in 1746, "their culture was completely obliterated on purpose, by the British," for the same reason they were to obliterate aboriginal cultures in North America, and to the same effect.

England created a truly market society by the early 19th century. This was in part achieved, Alexander argues in his 2001 essay, "through a massive, forced eviction of the rural poor from their farms, commons, and villages and the absorption of some of them into urban slums and a brutal, export-oriented manufacturing system. Those who resisted these new realities too strenuously were further dislocated from their families and communities, by forced apprenticeship of their children, destruction of their unions and other associations of working people, elimination of local charity to the 'undeserving poor,' and by confinement in 'houses of correction.'" Unlike First Nations people, the Scots already had alcohol. But only after their cultural collapse did alcoholism become a problem among the Scots.

Alexander argues that global trade, war and chemical addiction have long gone hand in hand. (Google the British opium wars for more of the same.) Only now, with globalization colonizing the last remaining public spaces, and even consciousness itself, are we starting to understand the sophisticated manipulation behind the market's addictive offerings. Alexander sees drug addiction as a species; the genus is addiction in its many forms, from online gambling and porn to video games and retail therapy. Wherever social networks are fraying, or already threadbare, addictions acquire greater force.

"We need to belong; we get that socially," he said in his speech at the Wosk Centre. "If we don't have it in our society, we get it through addictions. So if you've got nothing, a void in your life, you can join the addict culture in the Downtown Eastside, you can just go... pull out a $20 bill and you're in." Without proper psychosocial integration, even the most harmful substitute lifestyles serve a function, he insists. "For example, devoted loyalty to a violent youth gang, offensive as it may be to society and to the gang member's own values, is far more endurable than no identity at all."

Of course, people aren't just pieces of flotsam knocked about by historical forces. We all have free will, and not all of us spiral downward when deprived of psychosocial integration, ending up on the streets. But Alexander argues effectively that the pharmacological aspect of addiction has been overly emphasized through questionable research and knee-jerk politicking, at the expense of the larger social context, in which troubled people seek to anaesthetize themselves to their surroundings.

It's a no-brainer that the War on Some Drugs had failed spectacularly across south of the border. (A 2004 U.S. Justice Department report found that people sentenced for drug crimes accounted for 21 per cent of state prisoners and 55 per cent of all federal prisoners. With a global prison population estimated at nine million, the U.S. holds about one-quarter of all prisoners on the planet. Forty-one per cent of them are black.) So what would a Conservative-led crackdown on safe injection sites and drug trafficking offer for us that's any different than the American experience? Nothing.

Alexander's answer to the drug problem is greater investment in social housing, reforming public services, and rebuilding welfare and unemployment insurance so people have economic, social and psychological stability. "Perhaps, most important, we need to restore the credibility of Canada as an honourable, sovereign nation, rather than a puppet of the United States."

One piece of folk wisdom holds that "drugs are for people who can't handle reality." Would it be so unthinkable to suggest, along with Alexander, that we then work on changing reality?

Geoff Olson © Vancouver Courier 2007

Bottoms up for British Columbia booze prices?

A health pitch for the government: the lower the alcohol content, the lower the price.

The legislature's finance committee unveils its recommendations this afternoon, and there was an intriguing flurry of last-minute activity to do with liquor pricing that makes one wonder.

The committee will be forwarding suggestions to Finance Minister Carole Taylor for next year's budget. The ideas come from hundreds of submissions from the public, including people who showed up at public hearings the MLAs held around B.C.

The deadline for submissions was in late October. But in the first week of November, two doctors popped up at the committee's last working session and got their own hearing.

One of them was the Provincial Medical Health Officer, Dr. Perry Kendall. He got the special invitation to appear based on his status and expertise.

And he brought with him Dr. Tim Stockwell, the director of the University of Victoria's Centre for Addictions Research, and a recognized expert in alcohol-related policy.

The pair made a fairly compelling pitch for a significant change in the way booze is taxed and priced in B.C.

It's in line with B.C. Liberal thinking on health policy and it could conceivably raise up to $88 million a year to deal with the addictions that underlie homelessness, street crime and other social problems.

Kendall said the concept could ease the burden on the health and justice systems, improve community safety and be a wellspring of revenue for prevention and treatment services.

Part of the idea is simply to price and tax wine, beer and spirits according to their alcohol content.

The lower the alcohol content, the lower the price. It's almost the reverse of the current pricing scheme, Stockwell said.

He published the proposal a year ago, based on what his native Australia has done with booze taxes. It's been circulating since then and has attracted enough attention that the politicians from both sides of the legislature were keen to hear about it first-hand.

"A fundamental suggestion is that tax rates should take account of the health, social and economic costs of the product," he told MLAs. "This is no ordinary product ... The main thrust of my point today is that the way alcohol is priced through the liquor stores actually gives more incentives for people to choose higher alcohol-content drinks than lower alcohol-content drinks."

Stockwell's analysis of B.C.'s liquor pricing is that the incentives "are all the wrong way around."

Beers with less than four-per-cent alcohol are relatively more expensive than more potent brands.

Pricing for coolers -- fruit drinks mixed with alcohol -- leans even heavier in favour of encouraging people to buy higher alcohol-content brands.

Stockwell said the change could be revenue-neutral, in the sense that the price relationship between beer, wine and spirits would be maintained.

It would amount to a difference of several dollars between a case of lower-alcohol beer and a higher-alcohol case. There'd be a similar difference in wine and spirits.

He said the centre is also releasing a study next month showing most people can't tell the difference between low and mid-strength beer. (They tested some UVic students with a pub night and found "they enjoyed themselves just as much with the 3.8 per cent as the 5.5 per cent.")

And people don't necessarily just drink more. Stockwell said it's hard to get drunk on low-alcohol beer, because people fill up too quickly.

The revenue projections stem from a related idea -- a flat five-cent-a-drink levy dedicated to harm reduction.

And both doctors stress there is a lot of harm that needs to be reduced. Absolute alcohol consumption per adult has increased continuously in the last six years. Kendall said there's been a "substantial increase" in hospitalizations for alcohol-related conditions.

Neither of them brought up one of the obvious reasons for the increase in consumption -- the proliferation of private liquor stores brought on by the Liberal policy. There are now 1,273 liquor stores in the province, hundreds more than a few years ago.

Said Stockwell: "We read in the papers every day about the seriousness of this problem and the lack of resources to deal with it."

A five-cent levy in Australia generally went over well with the public, he said.

"They hate alcohol prices going up, but if they see the funds going toward a useful function like more treatment ... that's usually supported."

It would encourage local production of more low-alcohol drinks, reduce alcohol-related deaths and injuries and be accepted by the public, he said.

There's no telling whether the concept will make it into the report being released today. And even if it does, it still has to go to the finance minister for consideration before it makes it into next February's budget.

author: Les Leyne

© Times Colonist (Victoria) 2007

How alcohol killed my son at 23

Chris died earlier this year at the age of 23 as a direct result of alcohol abuse. Here his mother Kathy describes how her only son went from a thoughtful little boy to a desperate alcoholic.

"It's funny looking back now, how strongly he objected to alcohol at the age of nine or 10.

His father had been an alcoholic and had committed suicide when Chris was just six. But I had thought that together, we had come to terms with this and moved our lives on.

He wasn't one of these 12 or 13-year-olds you read about downing cider in parks. He didn't have his first drink until he was 15, and he certainly wasn't out bingeing then.

He was working hard at school, and left with 12 GCSEs.

It wasn't until he was 17 and he went to college that I think he started drinking regularly - or at least that was when I started noticing it. There was cannabis too, with his friends.

But I think a lot of the drinking was going on at home, secretly. I clearly remember at Christmas that year noticing that a bottle of spirits was missing.

Violence and shoplifting

At 18, he inherited £20,000. I had no control over how he spent this money. Some went on a motorbike, the other £15,000 was spent on alcohol and drugs.

But the strange thing was he never smelt of alcohol, or even appeared intoxicated. His father was the same, and I think it allowed Chris not just to hide it from other people, but also stopped him from facing up to his own problems.

I was also starting to suffer violence from him. But I never really confronted him over this or called the police in because I was scared stiff of alienating him at a time when I felt he needed to be close to me.

There was shoplifting too. We were in the supermarket together and he concealed a bottle of vodka. He was arrested, but I paid the penalty to avoid him having a criminal record, because I was still convinced he would turn a corner.

He dropped out of college and flitted from job to job. He went to see the doctor who said he was depressed and prescribed him something like Prozac.

Letting go

He started to suffer from great social anxiety, and was unable to go out. During the day he would come to work with me and sit in the car all day waiting for me.

He just got put on more anti-depressants.

One day he said to me: "Mum, today I crossed the road and nearly got knocked down by a car. And do you know what? I just didn't care."

I tried to get him psychiatric help with limited success but I was absolutely terrified that he was about to take his life.

The GP came out to see him, and for the first time he was prescribed a detox programme.

But there was no medical supervision for this. I got rid of all the alcohol in the house, although he must have still had a secret stash. But when this ran out he asked me to go out and buy him a bottle.

I refused, and he assaulted me. I knew this time I had to call the police, and I did. They arrested him, charged him.

Saying goodbye

The police advised me not to take him back.

This was the toughest decision any parent will ever have to make, but I felt then it was the right one. I felt he would have to hit rock bottom if he was ever going to turn a corner.

He stayed with friends, he was due to stay with my sister-in-law in London. He was in contact with my sister so I had tabs on him, but I knew if I spoke to him he would just try to come back.

We did sort out accommodation for him but it didn't work out. He thought he then had a place at a centre, but he had to be completely detoxed for them to let him in.

Then there was nothing - we didn't hear anything.

Finally, there was a phone call from the local hospital. I was told my son was there, and that I shouldn't come in without support.

He had caught streptococcal pneumonia because his immune system was impaired as a result of liver disease. Every organ was affected.

I sat with him through the night. At 4am, the nurse told me he was deteriorating. I had to leave the room at 7am for a shift change, and when I came back it was clear they were scaling down the level of care.

It wasn't long then.

Nobody's problem

I guess I feel let down by the system. With both him and my husband I wanted them sectioned for mental health because I felt that was the only way, but I was told it wasn't possible.

Alcoholics can't take responsibility for their own lives, but then doctors won't step in and take responsibility for them.

Of course the government can also do more, although raising taxes on alcohol probably wouldn't have made much difference to my son. However the fact it is so easily available - and appears so glamorous in adverts - is part of the problem.

But I think both as parents and a society we need to think hard about this. Why are kids now turning to drink at such a young age? I think schools are letting them down a lot of the time by failing to give them any fixed aspirations.

Some of my son's friends at college moved from computer courses to health and safety ones in the blink of an eye, without anyone asking them what they actually wanted to do with their lives.

There needs to be more education in schools on the dangers of drinking, for the kids and for the parents too. That must be a priority.

I wish my son was out there still, although there is some respite in death for someone who was always going to find living hard.

I say to myself: at least I know he is safe now."

source: BBC News

Drunk for £1: Anger as leading supermarkets sell lager for 22p a can

Supermarkets are selling beer at a cheaper price than water, fuelling concern over their role in Britain's binge-drinking crisis.

Despite repeated public health warnings, Tesco, Sainsbury's and Asda now offer lager at just 22p a can - less per litre than their ownbrand-mineral water and cola, and cheap enough to allow someone to get drunk for just £1.

An investigation by The Mail on Sunday has uncovered a fierce alcohol price war between the major supermarkets.

Lager is now so cheap that the stores pay more in excise duties than they charge at the till.

When production costs and overheads are taken into account, experts estimate shops are losing up to 8p a can.

Public-health bodies, doctors and MPs were furious when confronted with the findings.

Don Shenker, director of policy for Alcohol Concern, said: "There is no justification for the sale of lager at such a ridiculously low price.

"The fact that it is cheaper than their own brand of cola per litre is appalling.

Is 22p lager going to encourage binge drinking? Join the debate in readers' comments below...

"This sends entirely the wrong message to the young drinkers we are trying to steer away from alcohol abuse.

"They will think that if it's so cheap, it must be OK. We would urge the supermarkets to seriously review their pricing policy."

The last time lager was this cheap in pubs was 1975, but the supermarket price plunged to a new low last week following "tit-for-tat" measures between Tesco and Asda.

Last Monday, Asda slashed the price of Smart Price Lager to just 22p for a 440ml can following a similar move from Tesco.

Both stores now match Sainsbury's, whose Basics range has sold at 22p since June 2005.

This means that all three supermarkets are now selling cut-price lager, with an alcohol content of between two and three per cent, at 50p a litre - or just over 28p a pint.

By contrast, bottles of own-brand mineral water cost between 56p and 92p a litre, depending on the store.

Furthermore, a six-pack of 330ml cans of own brand cola costs between £1.11 and £1.29, or 56p to 65p a litre.

The situation may be about to deteriorate.

In an unprecedented move, Asda last week cleared their shelves of single cans and replaced them with multi-packs, forcing customers to buy in bulk.

The supermarket is the first of the major stores to introduce such a policy.

But critics fear that rival stores will be forced to follow suit to keep pace in a ferociously competitive market.

Sandra Gidley MP, public health spokeswoman for the Liberal Democrats, said: "Britain is in the midst of a binge-drinking crisis and prices like these do not help. The supermarkets constantly talk about their corporate social responsibility - maybe they should start practising it."

Experts are particularly concerned with the effect of low prices on children's alcohol consumption.

Last week, the Government admitted that the number of youngsters treated for alcohol abuse had rocketed by 40 per cent in just one year.

Figures obtained from the National Treatment Agency showed that children as young as ten are suffering illnesses usually present in ageing alcoholics and entering rehabilitation programmes in ever-increasing numbers.

A day after Asda slashed its beer prices, a report by Alcohol Concern found that supermarket alcohol is now so cheap that children could buy it using just their pocket money.

The Royal College of Physicians is so alarmed at the effect cheap alcohol is having on public health that it is forming an alliance with 21 other health groups to lobby the Government for a ten per cent rise in alcohol tax

Ian Gilmore, president of the Royal College, said: "There is clear evidence that the drinks industry is not behaving responsibly on alcohol pricing. Beer, wine and spirits are not ordinary products.

"They are legal drugs and should not be sold as a loss leader."

Last month, a Competition Commission inquiry into supermarket dominance of the retail market found that stores were selling alcohol at a loss to entice customers through their doors.

That commission revealed that during the 2006 football World Cup, Britain's four biggest supermarkets sold £12.7million of beer, wine and spirits below cost price.

However, the figures were disputed by some supermarkets.

Evidence from Finland also suggestsa link between price and consumption. There, tax on alcohol was slashed by 40 per cent in 2003.

Since then, drink sales have soared 11 per cent.

The glut of cheap beer on supermarket shelves has sounded alarm bells at top levels.

Professor Mark Bellis, from the North West Public Health Observatory and the Government's leading adviser on alcohol, said: "Of 15-year-olds, nearly two-thirds have drunk in the past four weeks, and around one in seven of those drinkers consumed enough to vomit.

"The reality is that about 30 per cent of all 15-year-olds think it is OK to get drunk once a week.

"We need to tackle a youth culture in which drunkenness is commonplace-underage access to alcohol relatively easy and alternatives to drinking far too scarce."

Robin Touquet, a consultant in the accident and emergency department at St Mary's Hospital, London, said: "Alcohol is a drug. It's a toxin and in inexperienced drinkers it can be dangerous.

"It doesn't matter what the level of alcohol in the drink is, if you drink enough it's going to have exactly the same adverse effects that higher percentage drinks such as wine and spirits have."

The Department of Health has announced a review of drink supply rules which may mean new restrictions on the sale of alcohol and tougher action against stores that sell to under-18s.

A spokesman for Asda said: "We were reluctant to bring our price down but we are the price leader and we cannot afford to be exposed by our rivals. It is a competitive market and if someone is offering something at a ridiculous price, we have to match it."

A spokesman for Tesco declined to comment on specifics but released a statement that read: "In common with other retailers, we sell a range of beers at different prices to suit all budgets.

"Our research shows that most of the alcohol purchased by our customers is bought as part of the weekly family shop."

A spokesman for Sainsbury's said: "The vast majority of our customers who buy alcohol do so as part of their regular, large grocery shop.

"Our research shows that they consume it over a period of weeks and months or they buy it for a special occasion such as a party."

A Department of Health spokeswoman said: "The Government has commissioned an independent national review of evidence on the relationship between alcohol, price, promotion and harm and following public consultation the need for regulatory change will, if necessary, be considered."

source: BBC News

First-Time Offenders Cause Most Alcohol-Related Deaths, Injuries

Those who study Wisconsin drunken driving issues said that chronic, repeat drunken drivers are a significant but small part of the overall problem.

Officials said that repeat offenders don't kill or injure most of the people involved in alcohol-related crashes. Experts said that to really cut down on injury and death on Wisconsin roads, we must address the most frequent offender: the regular citizen who has absolutely no drunken driving background.

One such man warned that if people don't think they will kill people while driving drunk, they should think again.

"I was on my way up north and I had been drinking. I drank and drove in the car, and I drifted across the center line of the road, and I hit another car head on," said John Luznicky. "The woman in that car, her name was Sharon Warner. She was 34 years old. She had a little boy and a little girl and she died instantly."

Luznicky said it is difficult to describe his thoughts after the crash.

"I don't know how to explain that feeling. It's a numbness; it's a shock. It's despair, hopelessness; it's helplessness," Luznicky said. "I don't know what the words are. I don't know if there are words to describe that feeling."

Luznicky's blood-alcohol level was 0.14 after the crash. The legal limit to operate a motor vehicle is 0.08 in Wisconsin.

It was the first time he had been arrested on drunken driving charges.

"I never thought it was going be me. I never thought it was going to be me. I thought it was going to be the other guy," Luznicky said. "I didn't think I was drunk. I didn't think was too impaired too drive. Was I? Oh, yeah, you bet. But did I know that was going to happen? No."

Experts said the people with no prior drunken driving history, not repeat drunken drivers, kill and injure the vast majority of people involved in alcohol-related crashes.

"And you hear the stories about the repeat driver and you hear the stores about people doing all these other things and you just think it's going to be somebody else, just not going to be me. But I'm here today to tell you it is me. It was me. I did what I did, and I've got to live with that," Luznicky said.

"The problem is people who drive drunk, and yes, the people who are ninth and tenth offenders. That's very offensive to us because we can't understand it. But they're just part of the big problem, and it's the overarching problem that will kill," said Nina Emerson, of the Resource Center for Impaired Driving at University of Wisconsin-Madison Law School.

Luznicky was married with four children when he was convicted of homicide by intoxicated use of a vehicle in 2001.

"I went to the school plays. I went to the parent-teacher conferences. I go to church. I owned a business. I didn't hang out at the bars -- that wasn't what I did. But I drank and I did drive and one woman had to pay for that with her life," Luznicky said. "I've been able to figure out how to live with it. I've been able to figure out how to make peace with it. But it doesn't go away."

"A woman's dead and there's two kids who don't have a mom because of me, because of what I did, and I've got to live with that," Luznicky said. "I mean, the damage is tremendous, absolutely huge. You can't begin to fathom how far it goes."

For more than five years, Luznicky has been speaking to anyone who would listen. He promised the victim's family that he would.

"I promised I would do whatever I could to try to prevent this from happening to somebody else, and that's what I'll try to do," Luznicky said.

Luznicky said he has to live with the hurt he caused his own family as well. His wife came upon the fatal crash scene as he was being taken away in an ambulance. Luznicky, a former landscaper, is now an alcohol and drug abuse counselor.

Many might think they can drink and still make it home, but statistics show that is a dangerous misconception, WISC-TV reported. One Department of Transportation study looked at more than 10,450 drivers over 12 years. All the drivers were drinking and in a crash that resulted in one or more deaths or incapacitating injuries.

The study found that three out of four drivers had no prior convictions for operating while intoxicated or related traffic offenses on their driving records.

So what can be done to combat the problem of drunken driving on Wisconsin's roads?

Experts said that when it comes to penalties for a first drunken driving offense, the humiliation of getting arrested works for the vast majority of people and they don't do it again.

But experts pointed to a couple of issues for debate when it comes to deterring people altogether.

They said one possibility would be for Wisconsin to criminalize a first-time operating while intoxicated offense. Wisconsin is the only state in which it is still a civil offense.

First-time offenders are fined between $150 to $300, given a $355 surcharge, a six-to-nine month license suspension and a mandatory alcohol assessment.

But even those civil penalties are watered down for drivers who are prosecuted under the Prohibited Alcohol Concentration Law. Drivers who have a blood-alcohol level between 0.08 and 0.99 lose their license for a time and pay a flat $250 fine.

"It just makes it an absolute joke that somebody could be stopped, arrested, convicted of OWI and just because they're 0.09, which is still above the legal limit, that they pay $250 and that's it. They pay $250. That's it," Emerson said.

Emerson and Dane County prosecutors said that one factor contributing to the problem is that alcohol is so widely accepted and promoted in Wisconsin. But they said that's not a problem as long as people act responsibly. They said people should make a plan for how they are going to get home before they go out drinking.

source: WISC Madison

Addiction Treatment May Benefit From Nicotine-Alcohol Interaction Study

The interaction between nicotine and alcohol, two of the most abused and co-abused drugs, can impact a person's ability to learn and could have implications for treating addiction, according to researchers at Temple University.

The researchers, Thomas J. Gould and Danielle Gulick, presented their findings, "Acute, chronic, and withdrawal from chronic nicotine interacts with acute ethanol to modulate fear conditioning," at the annual meeting of the Society for Neuroscience in San Diego. The study has also been accepted for publication in the peer-reviewed journal, Psychopharmacology.

"Whenever someone uses these two drugs together, there must be a reason why," says Gould, an associate professor of psychology at Temple. "The goal of our research is to understand the interactive effects of these two drugs and, by understanding how they are altering behavior and producing neural changes, we will hopefully be in a better position to develop treatments for drug addiction."

In examining the drugs' interactive effects on learning, the researchers looked at the ability to learn and process contextual information, which is important for multiple reasons. According to Gould, contextual learning taps into the part of the brain that is involved in declarative memory processes that define who we are, such as memories of our family, our wedding day, or graduating from school. This type of learning involves an area of the brain called the hippocampus, an area that is involved in strengthening short-term memories, and putting them into long-term memory storage, thus making those memories the ones that define who we are.

"We wanted to see if nicotine and alcohol are interacting in the hippocampus, or at another level, and what processes within the brain are they interacting with," Gould says. "If we can understand how these neural processes are changing and how they interact, then when someone is going through withdrawal or experiencing a cognitive deficit because of one of these two substances, we then may be able to use a therapeutic that blocks or activates a receptor, or that blocks a certain pathway which prevents the occurrence of the withdrawal symptoms and falling back into relapse."

Using an animal model, Gould and Gulick examined the effects of alcohol and nicotine on learning to determine what happens as the drugs are combined at different doses and different stages of administration.

"Our study showed that initially nicotine in a dose-dependent manner reverses alcohol-induced deficits in learning, but tolerance develops for this effect of nicotine with continued administration," he says. "We also found that a low dose of alcohol reverses nicotine withdrawal-associated deficits in learning. Furthermore, we found that chronic nicotine produces cross-tolerance to the effects of a low dose of alcohol on learning."

What does this all mean in terms of addiction?

"Think of a situation in which somebody is drinking and having cognitive difficulties," says Gould. "Smoking may take the edge off of it at first, so they begin smoking and they smoke more and more until tolerance develops and they lose that edge.

"Now they are drinking and smoking and they are addicted to both," he adds. "But if they try to quit smoking, they go into nicotine withdrawal, which results in a learning deficit. Maybe a drink will actually help them out initially, but then they consume more and they develop even worse learning deficits, so now they begin smoking again and they end up relapsing."

According to Gould, this could feed into a spiral in which initially nicotine and alcohol each block the adverse effects of the other. But as that happens, he says, smokers and drinkers develop tolerance and consume greater amounts of each drug, and then when they try quitting one or the other, they then have this cognitive deficit and may reach for either alcohol or nicotine or both to try and reverse it, but they just spiral into the addiction again.

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This study was funded by the National Institute on Alcoholism and Alcohol Abuse (NIAAA) and the National Institute on Drug Abuse (NIDA).

Source: Preston M. Moretz
Temple University